In Florida, to qualify for a medical marijuana recommendation, you must be diagnosed with one of the qualifying conditions determined by the Florida Department of Health Office of Medical Marijuana Use. These conditions range from physical ailments to mental disorders, one of which is Post traumatic stress disorder (PTSD). In this post, we will go over what PTSD is and how the endocannabinoid system may play a larger role in the disorder than most people think. 

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What is PTSD?

PTSD can be triggered by experiencing or witnessing a traumatic event. It can cause flashbacks, nightmares and severe anxiety in those who suffer from it. Usually, most people who experience such an event have trouble adjusting but can get better with time and care. Those with PTSD, however, have symptoms that can last months to years and may get worse [1].

The event that triggers PTSD may also trigger other related conditions. Such conditions include acute stress disorder, adjustment disorder, anxiety disorders, reactive attachment disorder, and disinhibited social engagement disorder. Those with PTSD may also experience depression, obsessive compulsive disorder (OCD) and are at risk for substance abuse [2]. 

Treatment of PTSD is complex, and usually involves multiple kinds of therapy and, in some cases, medication. Psychotherapy is usually used and can take several forms. Research shows that cognitive processing therapy, exposure therapy, and group therapy are especially effective. Generally, people with PTSD have also found help in improving the related conditions that may come with PTSD. For example, successfully treating anxiety and depression can help improve PTSD symptoms. Outside of therapy and medications, it can be helpful to start certain alternative treatment regimens, such as yoga and meditation [3]. 

How is the Endocannabinoid System Related to PTSD?

Recently, the endocannabinoid system has been pointed out as being related to certain “biomarkers” for PTSD and some other conditions. But why is this important? To start, biomarkers have become a hugely influential finding both in clinical practice and research. The is that there are “objective indications of [the] medical state observed from outside the patient”. Essentially, it means that there are signs of a condition or disease that we can measure. This may sound obvious for certain conditions, such as the flu or chickenpox, but applying to a mental disorder is a huge step. It could explain why one person with a disease responds to a medication while others don’t, they have different biomarkers and therefore different courses of action. 

In the case of PTSD, the endocannabinoid system has previously been shown to be involved in both the disorder in question and depression, another related condition [4]. It was found that the synthesis of a chemical called allopregnanolone was lower in people with PTSD and when allopregnanolone levels rose, symptoms were alleviated [5]. The synthesis of this chemical is at least partially regulated by the endocannabinoid system. The system has also been shown to have strong effects on fear acquisition and fear extinction, two important components of PTSD [6]. 

One difficulty of PTSD comes from its biological cause. That is to say, we are able to diagnose it, but the part of the brain causing the problem is still largely unknown, hence the multi-pronged treatment. This may be due to the nature of the disorder, rather than being a simple “on-off” trigger it may be due to several parts of the brain working together abnormally, making it even more difficult and complex to determine a cause. 

Since the discovery of the endocannabinoid system’s role in some psychiatric disorders was found, studies have started to look into the therapies targeting the system. For example, one study states that their results “strongly suggest that exogenous cannabinoids administered in proximity to trauma exposure could prevent the development of PTSD-like symptoms” in animal models [7]. 

Some other studies look for cannabinoid therapy to help those with PTSD. One such experiment used Nabilone, a synthetic form of THC, to help reduce the number of nightmares PTSD patients experienced. The study found that 34 out of 47 patients had either a cessation or significant reduction in the number of nightmares experienced [8]. Another study found that, by adding THC to existing medications, the cannabinoid improved sleep quality, reduced nightmares, and reduced symptoms of hyperarousal. 

Even beyond PTSD, the endocannabinoid system and cannabinoids themselves have been found to have strong effects. Considering the severity of PTSD’s related conditions, cannabinoid therapy opens exciting possibilities. Studies have shown marijuana to be effective in anxiety reduction, relieving depression, and as a sleep aid. 

In Summary

PTSD is a devastating disorder that can have far-reaching implications in a person’s life. It has been found that the endocannabinoid system does play a role in the disorder, and a deficiency in a chemical regulated by the system may be an important marker for those susceptible. Luckily, research also suggests that there are ways to overcome the disorder, such as therapy and certain medications. It is also suggested that future medicine may make use of the endocannabinoid system and marijuana to reduce or fight some of the symptoms associated with the condition. 

 

Resources

[1] https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967 

[2] https://www.nami.org/learn-more/mental-health-conditions/posttraumatic-stress-disorder

[3] https://www.nami.org/Learn-More/Mental-Health-Conditions/Posttraumatic-Stress-Disorder/Treatment

[4] https://www.ncbi.nlm.nih.gov/pubmed/16934764/

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091574/

[6] https://www.ncbi.nlm.nih.gov/pubmed/18308796/

[7] https://www.degruyter.com/view/j/jbcpp.2016.27.issue-3/jbcpp-2015-0058/jbcpp-2015-0058.xml

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719095/